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Knee Injuries: Q&A with Mr Mahbub Alam, Consultant Orthopaedic Surgeon at Highgate Private Hospital

Mr Mahbub Alam is a Consultant Orthopaedic Surgeon with a specialist interest in knee injuries and knee replacement surgery. He is widely published in knee ligament injuries, knee replacement, patella instability, jumper’s knee and the prevention of blood clots following joint replacement surgery.

Mr Alam is available for patient appointments on Tuesday mornings every week at Highgate Private Hospital. To book an appointment please call 020 8341 4182 or email enquiries@highgatehospital.co.uk

 

Q: What is a meniscus and how can my meniscal tear be treated?

Each knee has 2 meniscii which are responsible for reducing the force passed across the knee (“shock absorption”) and increasing knee stability. Injuries can cause tears leading to pain, locking, clicking and/or swelling. They are treated by keyhole (arthroscopic) surgery and resection of the tear (partial menisectomy), or repair. Partial menisectomy is a daycase operation and offers early rehabilitation. Meniscal repair is also a daycase procedure but can only be carried out if certain criteria are fulfilled. It has a more prolonged rehabilitation but does offer the possibility of restoring the full function of the meniscus.

Q: Should I have my Anterior Cruciate Ligament (ACL) tear reconstructed?

An ACL tear doesn’t necessarily require reconstructive surgery. Patients who have reduced exercise demands, especially if they avoid ‘cutting’ exercises, and with minimal symptoms of the knee ‘giving way’ may be managed with targeted physiotherapy and lifestyle modifications. More active patients, especially if the knee gives way during exercise or everyday activities, are more likely to need surgical reconstruction. All patients need rehabilitation, whether they undergo future surgery or not, to improve knee movement and muscle strength and balance. However, it is important to have a consultation with a Knee Surgeon as there are often associated injuries with the ACL tear such as meniscal tears and articular cartilage damage.

Q: I have severe knee arthritis, should I have a partial (unicompartmental, UKR) or total knee replacement (TKR)?

The knee has 3 compartments (inner or medial, outer or lateral and behind the kneecap or patellofemoral joint/PFJ). If it is osteoarthritis (OA) and the disease is only severe in a single compartment then only that compartment can be replaced by a UKR. There are other factors, such as a functioning anterior cruciate ligament (ACL), which need to be fulfilled. As less of the knee is replaced, the surgery is knee preserving, less invasive and offers earlier rehabilitation. The knee may also feel more ‘normal’ compared to a total knee replacement (TKR). However, the partial knee replacement may last for a shorter length of time compared to a total knee replacement, due to multiple factors. This can mean the unicompartmental knee replacement procedure that a patient’s already had, may need converting to a total knee replacement sometime in the future. If the arthritis involves more than a single compartment or patients are older, have lower physical demand or other health problems they may consider opting for a total knee replacement. Knee surgeons will be happy to discuss this and other joint preservation options with you in more detail.

Q: What is kneecap (patella) dislocation and what treatments can help?

The patella is critical for quadricep muscle function and is particularly important in standing from sitting and going up and down stairs. The patella moves or “tracks” in a groove at the front of the femur because of a balance between bony and soft tissue structures. Physical rehabilitation, aimed at restoring the muscle balance around the kneecap, plays a critical role in both non-surgical and surgical treatments. CT or MRI help to confirm the underlying cause(s). Any treatment option chosen should be aimed at restoring, if needed, the underlying bony and/or soft tissue structures.

 

A private consultation with Mr Alam at Highgate Private Hospital costs £220 if you don't have health insurance.  To book an appointment, call us now on 020 8341 4182 or email enquiries@highgatehospital.co.uk

You can also see one of our Private GPs if you prefer, with whom appointments can be booked through the same team.

 

Copyright, Mr Mahbub Alam, 2016

Date: 24/05/2016
By: Mr Mahbub Alam - Consultant Orthopaedic Surgeon
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